States did little to improve healthcare access, quality, costs and outcomes in the past five years, according to a Commonwealth Fund report. Researchers examined 42 health indicators between 2007 and 2012, and found that in many states, access and affordability of healthcare actually declined among adults younger than 65. Healthcare spending rose $491 billion, reaching $2.8 trillion nationally.

"We certainly were hoping that we would see more substantial progress across states; of course, this was a period of recession," said Cathy Schoen, senior vice president for policy, research and evaluation at the Commonwealth Fund, in an announcement about the report. However, combined federal and state actions can potentially promote performance gains throughout the country, the report noted